HIV/AIDS in Ethiopia: - Clinton Health Access Initiatives

EARLY INFANT DIAGNOSIS AND DRY BLOOD SPOT TESTINGIf left undiagnosed, half of all HIV-positivechildren will die before their second birthday.Recognizing the importance of knowing thestatus of HIV-exposed infants, the Early InfantDiagnosis (EID) program, funded by UNITAIDand managed by CHAI-Ethiopia’s LaboratoryServices team was started in 2007. Playing apivotal role in the Pediatric HIV/AIDS Programby helping to scale up treatment, over 30,000tests have been performed since the program’sinception, allowing thousands of otherwiseundiagnosedchildren the opportunity toreceive essential antiretroviral therapy.Unlike rapid HIV testing for adults, diagnosinginfants presents with its own unique set ofchallenges. Because exposed infants carry theirHIV-positive mother’s antibodies, conventionaltesting will often lead to a false HIV-positivediagnosis. Avoiding this error requires theuse of a highly-specialized laboratory test notwidely available in developing countries knownas DNA-PCR. To perform the test, centrallaboratories use blood samples taken frominfants via a process called Dry Blood Spotcollection (DBS). While DBS collection is simpleto administer on a clinical level—a small prickon the base of an infant’s foot will suffice—the process of testing DNA-PCR in the lab ismore complex. To ease implementation andmitigate error throughout, the CHAI-Ethiopiateam has packaged all the required diagnosticsupplies into what are known as “DBS bundles”and “Laboratory Consumable bundles”.Improving the materials, specifications andquality standards of these bundles has been ofpinnacle importance to CHAI throughout thelifespan of the project.The CHAI/UNITAID partnership recognizes theimportance of taking a holistic approach tolab development in Ethiopia. Working closelywith EHNRI, the Laboratory Services teamcontinues to build capacity in the EID programby improving access to essential diagnostictools and integrating higher quality standardsinto laboratory protocol. Since establishment,the program’s primary objective remainsthe same: to provide a catalytic scale up ofEID through the development of centralizedforecasting, procurement and distributionmechanisms in hopes that someday operationswill be managed entirely at a national level, thusensuring nationwide access to vital HIV/AIDsdiagnostic services for the next generation ofEthiopian children.EARLY INFANT DIAGNOSIS SCALE UPLABORATORY TESTING SUPPLY SCALE UP 1 184060000245005000040000300001300020000100004330700002007 2008 2009 2010 20112007 2008 2009 2010 2011*AMPLICOR TESTS DBS TESTS LAB CONSUMABLE TESTS *ProjectedANNUAL UNITAID COMMODITY DONATION: CHAI LABORATORY SERVICES INITIATIVE$122,281 $360,299 $478,519 $852,383 $143,024 $1,956,5062007 2008 2009 2010 2011 totalSource: 1 EHNRI25 CHAI and UNITAID in Ethiopia26